Provider Demographics
NPI:1114350972
Name:KIEDROWSKI, LESLI ANN (MS, MPH, CGC)
Entity Type:Individual
Prefix:
First Name:LESLI
Middle Name:ANN
Last Name:KIEDROWSKI
Suffix:
Gender:F
Credentials:MS, MPH, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 NE PACIFIC ST
Mailing Address - Street 2:K-216 HEALTH SCIENCES BUILDING, BOX 357720
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7720
Mailing Address - Country:US
Mailing Address - Phone:206-616-6376
Mailing Address - Fax:206-598-3269
Practice Address - Street 1:1705 NE PACIFIC ST
Practice Address - Street 2:K-216 HEALTH SCIENCES BUILDING, BOX 357720
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7720
Practice Address - Country:US
Practice Address - Phone:206-616-6376
Practice Address - Fax:206-598-3269
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAGP 60389131170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS